Healthcare Provider Details

I. General information

NPI: 1447713078
Provider Name (Legal Business Name): CATHERINE JACHTHUBER TRUB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE ELIZABETH JACHTHUBER

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MANNING DR
CHAPEL HILL NC
27599-6117
US

IV. Provider business mailing address

3630 SUNNINGDALE WAY
DURHAM NC
27707-5654
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-3172
  • Fax: 919-966-8419
Mailing address:
  • Phone: 404-735-8825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2022-00400
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number250620
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number2022-00400
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: